Breaking news on the debate on whether Gleason 6 is a cancer
Extra, Extra Read All About it
By Howard Wolinsky
My hometown paper, The Chicago Tribune, did a nice, balanced story on whether Gleason 6 out to be relabeled as noncancerous.
Headline: Is low-grade prostate cancer really cancer? University of Chicago doctor argues it’s time for a name change.
Read all about it here: https://bit.ly/3EKGCAh
The Trib’s medical writer Lisa Schencker reported: “Dr. Scott Eggener argues in a paper published in the Journal of Clinical Oncology on Monday that Gleason 6 prostate cancer should no longer be labeled as cancer.
“Gleason 6 does not cause symptoms or spread, he said. But the word “cancer” in the diagnosis likely scares some men into seeking unnecessarily aggressive treatments, such as prostate removal or radiation, he said. Having a diagnosis of cancer can also cause anxiety among patients and family and lead to trouble getting life insurance, he said.
“The word cancer has a lot of implications for the man, for the health system, for society,” said Eggener, a University of Chicago Medicine urologist and professor of surgery. “The patient now sees (himself) as a cancer patient. Many men still choose to get aggressive treatments that can have short-term or life-altering side effects.”
(TheActiveSurveillor.com was quoted in there as a co-author of the Journal article and a patient.)
Not everyone, however, agrees Gleason 6 should no longer be called a cancer. It’s been a topic of debate for 10 or 15 years, and many doctors feel it should still be classified as cancer, said Dr. William Catalona, a professor of urology at Northwestern University Feinberg School of Medicine.
“It is not like normal tissue,” Catalona said. He said removing the cancer label would be “a big mistake.”
For the record, Catalona suggested early on I get my cancer out. I had a single core of Gleason 6, only seen once in six biopsies. He is a distinguished surgeon. It was an unofficial suggestion. I have great respect for Bill, who has done so much for patients with prostate cancer. I decided to stick with Eggener. And last year Bill told me he made a mistake in judging my case.
Meawhile, I want to hear your opinion on this.
So far only 16 of you have answered a survey and so far there is heavy support for a name change:
Urgent: I’d like you to share your opinion in the comments and answer the survey: “Should the cancer label be removed from Gleason 6?”: https://www.surveymonkey.com/r/ZQHDQYK.
Finally, the webinar on the future of AS scheduled for 11 a.m. Eastern/5 p.m. CET on Friday, April 22 is filling up.
We have about 350 registrants from almost 20 countries, including US and Canada plus Australia, Belgium, Holland, Italy and Switzerland etc. Some surprising ones, too: Brazil, Bulgaria, Hong Kong, and Singapore.
"Your Voice in the Future of Active Surveillance," at 11 a.m.Eastern/4 p.m. GMT on this topic. April 22. Register here: https://bit.ly/3ueT9bc
ASPI and AnCan are the leads. About a dozen organizations have endorsed the meeting featuring an A-list of AS pioneers. See below.
As you so adeptly write, much of our life is influenced by whether G6 is cancer or not; insurance for instance over which we have little sway-it's their money; plenty of gray area! Were I now as I once was one of those terrified neophytes grasping at straws wrenched with deciding who to believe, what I'd want is not absolution unless universally acknowledged and that may never happen-let the debate rage on. No, I foresee the Active Surveillor becoming as important as our doctor. Each of us have our own biases which only become blaringly obvious lying on a couch at $200+/hour. Your articles in some odd way answers the question, for, acceptance of choice ultimately is ours and ours alone. The real challenge is ferreting out why our medical team which has immense impact on our choice-likely with believers either side of the argument-believes as it does. Lost in the diatribe of research and voice of patient oriented non-profits screaming to be heard is a quiet voice of few with an inner strength to emulate. Such is the editor of The Active Surveillor. Easy to accept Catalona's apology with a prostate intact; whole another matter 10
years earlier with his credentials.
Howard, I honestly don't feel qualified to come down on one side or the other in the survey. Maybe because I've had cancer before, I'm not particularly frightened by knowing about my G6, and I consider the infrequent biopsies the cost of doing business, so to speak. Either way, I'm leaving this one to greater minds.